Most of us take clean air for granted. That is…. until the sky turns gray with smoke or we wake up to an eerie Armageddon-like morning while the sun hides behind a thick layer of cloud. At those times, we quickly start to think about how we can best protect ourselves and our families from the smoke. I have young children, one of which has asthma, so this has been foremost on my mind over the last couple of smoky weeks.

August 17th, 9:30 AM Armageddon morning from my office.

Because I work in air quality at Northern Health, I have access to some great and easy to follow advice (and you can find it on the NH website too). Here are some strategies that my family and I have been following to keep us healthy during these smoky days:

Check on medication:
Since my son has asthma, the first thing I did was to make sure that his asthma management plan was up to date, that his regular medication was filled, and that we had enough rescue medication on hand to be able to manage his condition. I have been helping him to understand and follow his asthma management plan and keeping tabs on whether or not it is working. He knows when and how to use his rescue medication and we have talked about when we would go to the doctor for additional support.

Stay indoors:
While everyone reacts differently to wildfire smoke, it is important to listen to your body and reduce outdoor strenuous activity during very smoky conditions. Healthy individuals can still go outside and be active during less smoky periods, but for those with chronic conditions, the recommendation is to stay away from rigorous outdoor activity altogether when there is smoke in the air. Because of this, we have been keeping the kids indoors and keeping them occupied with various indoor activities. This has included activities like building with Lego, beading, and edible slime-making, and (for the safety of my breakables and all of our sanity) also more active activities, like going to the pool and our local civic centre. Public facilities, like community halls, malls, libraries, and pools often have better filtration systems and can offer a nice reprieve from being stuck in your home.

Making beads inside with the air purifier and smoky skies as backdrop. Photo credit: Franny Steele.

Pool time fun during smoky days. Photo credit: Franny Steele

Keep inside air clean:
Of course, when staying indoors, it’s important to try to keep the indoor air clean. We try to open windows and doors only when needed. I also have two HEPA air purifiers running in the house. One of these is set up in my asthmatic son’s room so that he has a “clean” place to sleep at night. The other is in our common room where we spend most of our time. HEPA air purifiers are recommended over electrostatic precipitators (which can produce ozone) for those with respiratory conditions and the research (and my own experience) tells me that they really work!

It’s a good bet that this won’t be our last smoky summer, so even if you don’t have access to an air purifier this year, my recommendation would be to keep an eye open for deals on air purifiers for next summer season. I bought ours on sale for less than $50 each and they have been well worth it!

Stay put:
After posting multiple “Armageddon-like” photos on my Facebook page, I had calls from family located in other parts of the province, asking if we needed a place to evacuate to. At first I was surprised to learn that the public health advice for smoky conditions is not to evacuate, but it made sense once I understood the reasoning. One reason is that smoky conditions can change very rapidly. It is very possible that by the time we left our smoky hometown and drove elsewhere, the winds would have shifted and cleared our hometown air while socking in our new location. Smoke can travel for very long distances. With the number of fires burning in BC right now, we would need to travel quite far to find a place that couldn’t be impacted with a change in wind direction. I recently flew from Vancouver to Prince George and we were flying above smoky skies the entire way! Of course, evacuating is also stressful (especially with young children) and can be costly. On a regional scale, community wide evacuations for smoke can take important resources away from those whose safety is directly threatened by the wildfire.

Smoke conditions change rapidly! This photo is taking four hours apart from the same location. While still smoky, the smoke cleared up significantly between 9:30 am to 1:30 pm.

Don’t bother with masks:
Unless you’re required to as part of your work or have been advised by a physician, don’t bother wearing masks. Surgical masks (the thin white ones you can buy at a drug or hardware store) offer little protection from the fine smoke particulates. The ones that do (called N95 masks) are quite bulky, are harder to breathe through, need to be fit tested, can’t be fit tested on people with facial hair, and don’t fit children. The best line of defense is to seek cleaner air! Thank goodness, since I think asking the kids to wear masks would not have gone over well with them.

Don’t panic:
While very smoky days can be freaky, especially when you or your loved one has a chronic condition, I feel better knowing that most effects will go away quickly when the smoke clears. In a month from now when we are rummaging through our closets to find our winter gear, this will likely be a far off memory.

Barb is a healthy community environments lead for Northern Health. Her passion is her family, and most of what she does to stay active and healthy centers around activities such as biking, hiking, walking, skiing, swimming and boating, where the whole family can be involved.

To shed some light on a topic that is so often out of view, occurring at the level of tiny particles, I spoke with air quality meteorologist Gail Roth. She took me through a day in the life of someone who spends a lot of time amidst tiny particles with big health impacts!

How do we measure air quality?

The Ministry of Environment has two types of monitors, continuous and non-continuous, that are set up in communities all over B.C. We monitor all sorts of pollutants, including sulphur dioxide, nitrogen oxides, and more.

Because it’s the air pollutant that most often exceeds provincial objectives, a primary area of concern is particulate matter pollution – the tiniest of particles in the air that can get stuck deep in our lungs. These are called PM2.5 – particulate matter (PM) that is 2.5 micrometres or smaller in diameter. For comparison, a human hair is approximately 60 micrometres in diameter. PM2.5 is largely generated from combustion sources (e.g., vehicles, residential wood burnings, industrial processes).

We also monitor PM10 (particulate matter that is smaller than 10 micrometres). These larger particles are mostly caused by big particles like road dust, wood dust, or pollen being broken down.

In both cases, we measure how many of these particles there are in one cubic metre of air. You’ll see this reported as micrograms per metre cubed: µg/m³.

Although specific smoke conditions might change because of wind, fire behaviour, and temperature, a smoky skies advisory in your area means you can expect higher levels of particulate matter pollution. Photo courtesy of BC Wildfire Service.

What is an air quality advisory?

The provincial objective for PM2.5 levels in a 24-hour period is 25 µg/m³. When a community gets above or close to this level, we issue an air quality advisory. This lets people know that their breathing may be affected and that they should be taking action to protect their health and reduce their emissions. The annual objective, which we use to monitor long term PM2.5 levels, is 8 µg/m³.

The provincial objective for PM10 levels in a 24-hour period is 50 µg/m³. When a community gets above or close to this level, we issue a dust advisory.

If there’s a forest fire in your area, you may also see a smoky skies advisory. Although specific smoke conditions might change because of wind, fire behaviour, and temperature, a smoky skies advisory in your area means you can expect higher levels of particulate matter pollution.

What actions can I take to protect myself during these advisories?

We include these actions right in the advisories, so they can be a helpful tool in protecting your health. The overarching goal of these actions is to reduce your exposure to the poor air. Some specific actions include:

Avoid roads with heavy traffic and areas with wood smoke

Reduce or stop physical activity if breathing becomes difficult

Further actions, including staying indoors and running air cleaners, may be needed for those who are more sensitive, like seniors, children, and people with underlying medical conditions.

What else do air quality meteorologists do?

In addition to monitoring air quality and issuing public reports and advisories, there are two other main parts to our work:

Technical reviews: As an example, when an industry applies for a permit for a project that might have air pollution emissions, we review the application and evaluate its potential impact on air quality in the local community and surrounding area.

Supporting local airshed management groups: We help to start these groups and translate technical air quality information for them. Local members drive the groups and we’re a resource for them, providing support on the science side.

Where can I learn about advisories in my community?

I’d encourage everyone to visit bcairquality.ca. Whenever an advisory is in place, it will appear as a link on the homepage. Even if there’s no advisory, you can still find current air quality conditions for where you live as well as great resources.

More information

Do you have respiratory sensitivities or want to take extra precautions during wildfire smoke events?

There is a growing body of evidence to suggest that portable air cleaners (equipped with HEPA filters or electrostatic precipitators) are effective at reducing indoor particulate matter concentrations and the associated health effects during short smoke events.

Be sure to research products before purchasing a portable air cleaner! Learn about the type of unit you’re purchasing and the proper sizing for your space. On these devices, you’ll notice a number called the clean air delivery rate (CADR) – if you’re concerned about wildfire smoke, the CADR rating for tobacco smoke is the most relevant to look at.

When using a portable air cleaner, limit the entry of outdoor air. Keep in mind when you’re indoors and using a portable air cleaner, however, that there can be risks from increased heat and indoor-generated air pollutants.

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

The air we breathe has a significant impact on our health – beyond just our lungs! (Photo by Northern Health staff member Molly McRae)

Working in Public Health Protection has been rewarding. Whether it’s speaking to a mother about the cause of her baby’s stomach bug or teaching a food safety class to local food service workers, I’ve appreciated being part of the upstream efforts to prevent illness.

Now that I’m a parent to two small children and having just lost my mother to cancer, these efforts seem even more personal. Many of the choices we make each day can impact our exposures to infections and environmental contaminants. The personal care products we use, the food and water we consume, the lakes we swim in, the air we breathe – all of these can impact our health.

Recently, in my new role as Health and Resource Development Technical Advisor, I have been focusing a lot of my time on air quality.

Air quality in northern B.C.

I’ve learned a lot about air quality in the last 6 months, particularly about the amazing northerners committed to improving our air quality!

Here’s a quick sample of what I’ve learned since June – information that I think is important to share!

Did you know that in northern B.C., we have three very active community roundtables where stakeholders meet and tackle difficult air quality issues in their respective communities?

There are also air quality steering committees for the purposes of information exchange and health promotion activities.

There are passionate and talented scientists right here in B.C. researching what impacts our air and how this affects our health.

The health effects of poor air quality extend much more broadly than we’ve traditionally understood. In fact, the theme for the last BC Lung Association Air Quality and Health Workshop was “Beyond the Heart and Lungs“. Air pollution contributes negatively to many lifelong health conditions and even small improvements in air quality can have significant positive health impacts.

Smoke is of particular concern in the north. Why? Because it contains tiny particles called particulate matter (PM), and a large range of harmful compounds — the normal by-products of combustion. It may also contain small amounts of other proven and suspected cancer causing agents.

There are many sources of smoke in our airsheds and the most notable source is due to the increasing intensity and severity of wildfires in the summer.

I was surprised to learn, though, that air quality can be severely impacted in the winter months as well. I grew up in a home where we used both forced air and wood heat. It felt completely natural to sit in front of the woodstove to warm my toes and I have a fond association between the smell of creosote and my grandparents’ log home! Fast forward to today and I’m learning all about the harmful effects of wood smoke on the local airshed.

What can I do?

A couple ways we can reduce our impacts in the north is to only burn when absolutely necessary and to use efficient and clean burning practices. Learning about air quality is key, too! I’ve had the opportunity over the last few months to work on some key messages related to responsible wood burning to increase air quality awareness across northern B.C. You can find some of that information and more resources on Twitter, Facebook, and on Northern Health’s air quality site.

The local air quality groups in our region also have some great resources on their websites:

Finally, don’t miss the USEPA site for great information on burning and air quality.

Let’s take these steps so our families and neighbours can breathe easy!

Share your clean air tips and stories

How do you or your family reduce smoke or particulate matter during the cooler winter months? We want to read and share your stories about efficient or clean burning practices, alternatives to burning, and other strategies we can all use to minimize the smoke or particulate matter in our air.

Paula works in Prince George as a Health and Resource Development Technical Advisor, working collaboratively to assess and minimize health impacts related to industrial development. Born and raised in Terrace, she completed her schooling in Edmonton, and started her environmental health career in southeast Saskatchewan in 2005. She has been back in northern B.C. since 2010. Paula enjoys being creative, listening to music, and spending time with family and friends.

You know, it wasn’t that long ago that things were a lot different when it came to where a person can smoke. I can remember when smoking was allowed anywhere and anytime. It wasn’t considered hazardous to light up cigarettes in cars with children, in the office, or at a restaurant. You could even smoke on Northern Health property back in the day.

Northern Health is rolling out a new and improved Smoke Free Grounds policy that will go into effect at all facilities soon!

However, things have changed and now we recognize that a smoke free environment reduces many health risks for smokers and bystanders. Northern Health took action to create a smoke free environment by implementing a Smoke Free Grounds policy back in 2008. After a few years and a few tweaks (such as e-cigarettes and other vapour devices being included in the policy), Northern Health is rolling out a new and improved Smoke Free Grounds policy that will go into effect soon!

While some people might disagree with the idea of asking smokers to move off Northern Health property if they choose to smoke, the policy is supported by valid reasons:

It doesn’t matter whether you work for Northern Health, are a patient in-facility, or are visiting someone in the hospital. For the Smoke Free Grounds policy to be successful, everyone is going to have a role to play!

If you’re a staff member

Use Brief Intervention to identify tobacco users and address tobacco as a standard of care using the Nicotine Withdrawal Protocol and Registered Nurse Initiated Action.

Be a role model and adhere to the Smoke Free Grounds policy.

Use nicotine replacement therapy (NRT) products at work.

Let your patients know about the policy and support them in using nicotine replacement therapy products to manage withdrawal symptoms.

If you see someone smoking on Northern Health property, tell them about the policy. If you’re unsure of how to approach someone and talk to them about smoking on Northern Health property, ask a tobacco reduction coordinator.

If you’re a patient

Respect and adhere to the policy.

Ask your nurse about getting nicotine replacement therapy products while you’re in-facility. You can get help to manage nicotine withdrawal symptoms.

Look at this as a chance to go without tobacco. When you discover that your health improves by not using tobacco, it might lead to you considering quitting altogether. It’s also important to remember that by not using tobacco, you’ll heal quicker and get home faster!

If you do choose to use tobacco, remember that you need to leave Northern Health property to do so.

If you’re a visitor or contractor working on Northern Health property

Remember, the Smoke Free Grounds policy applied to everyone. Please respect and adhere to the policy.

At the end of the day, the Smoke Free Grounds policy is an important part of Northern Health’s efforts to create a healthy space for everyone.

Reg is a licensing officer with Northern Health and has his BA in Health Science. Previously, he worked as a Recreation Therapist with Mental Health and Addictions Services in Terrace as well as a Regional Tobacco Reduction Coordinator. Originally from Revelstoke, Reg enjoys the outdoor activities that Terrace offers, like mountain biking and fishing. Reg also likes playing hockey, working out, and creative writing. He is married and has two sons and believes strongly in a work/life balance as family time is important to him.

The health impacts of smoking and second-hand smoke are relatively well-known, but do you know about the dangers of third-hand smoke?

Third-hand smoke is the stale, smoky odour that lingers in the air that is left behind after a cigarette is extinguished. Electronic cigarettes and other vapourizing devices also leave behind chemicals for others to breathe.

It’s now common knowledge that smoking is harmful and breathing in second-hand smoke is equally harmful to the non-smoker. However, third-hand smoke could be harmful as well.

Like second-hand smoke, third-hand smoke is composed of toxic carcinogens like arsenic, lead, and cyanide as well as heavy metals. Although the visible cigarette smoke is gone, its particles can be deposited onto every surface of a home or vehicle. Sticky, highly toxic particulates can cling to clothes, furniture, flooring, ceilings, walls, hair, skin, toys and bedding. Gases can be absorbed into carpets, draperies, and other upholstery or even incorporated into the environment’s dust. These gases can still be inhaled long after a cigarette has been extinguished.

Third-hand smoke residue is a health hazard for children. Children breathe faster and can inhale more of the toxins. They also crawl on, play on, or are closer to the dusty, contaminated surfaces where the toxic chemicals lay in wait. This increases children’s exposure and puts them at greater risk from the harmful effects of third-hand smoke.

Third-hand smoke is also resistant to normal cleaning. Simply airing out rooms, opening windows, using fans or air conditioners, or confining smoking to only certain areas of a home does not remove the residue left behind from third-hand smoke.

Making homes, vehicles and schools smoke-free is the best way to avoid third-hand smoke.

Avoid exposure to third-hand smoke with these tips:

Do not smoke tobacco around children.

Shower and wash your hands after smoking.

Keep all surfaces clean.

Identify your home as smoke-free and do not allow people to smoke in your house or car.

Consider wearing a jacket or shirt that can be removed after smoking, especially when holding a child.

If you are a tobacco user, quit! Visit QuitNow for resources to help you quit.

A true Northerner, Doreen was born and raised in Prince Rupert and has lived in the north her whole life. She works in at the Public Health Unit in Prince Rupert as a Regional Tobacco Reduction Coordinator with Northern Health’s Population Health team. Doreen is passionate about tobacco reduction and has a strong interest in community development. Once contemplating a move to Vancouver Island, she chose to stay in Prince Rupert to raise her sons with everything the north has to offer. In her spare time, she loves sport fishing on the ocean, beachcombing on the white sandy beaches and hiking outdoors on the pristine mountain trails. When not at work, Doreen can be found at home, spending quality time with her family and friends and taking the odd bellydancing class.

I’m worried that soon – and for some of you this may already be the case – I will be stuck indoors as outside there will be two enemies of my personal health which will keep me imprisoned:

The smell of smoke in the air from a forest fire, which makes me cough.

That lovely sun, which recently hit 32 degrees for me, even in the shade. I took my wall thermometer off the wall to see what the temperature would be if I placed it in the sun. Within minutes it went to 42 degrees! Standing still for any length of time will do that to your skin, too! 42 degrees. Holy smokes! It was not quite a scientific experiment, but all the same, it was very hot!

The recent headlines and my past experiences during this time of year got me thinking about wellness and all the other issues related to these two conditions, like air quality advisories and sunscreen.

At one point last year, my local air quality health index was at 7, which is high risk. Given the current fire situation, I suspect that I’ll see that number again this year – some of you may have already. You can check your local air quality at bcairquality.ca.

So, what’s the advice given to those of us with respiratory ailments, children and the elderly at these levels?

Take it easy, stay indoors if you can (well, yes, it may also be plus 30!), and try and avoid strenuous activities during the period of the warning. This, I should say, also applies to the general population. If you are working outside and it’s causing you to cough, maybe you should take it easy, too. Catch up with the yard work another time.

And did I mention sun? I don’t think I have to tell folks these days that as beautiful as it is, it also harbours some dangers in the form of skin cancer from too much exposure. Use a sunscreen with an SPF of 15 or higher and spend as little time in the sun as possible. Higher SPF doesn’t mean you can stay out longer! Also, try to cover up as much skin as possible, especially if you are as fair as I am, and especially on top of your head.

Lastly, keep an eye on local air quality advisories, especially if there are forest fires out in your area as exposure to smoke and particulates can trigger asthma and worsen other respiratory ailments.

Jim is a tobacco reduction coordinator with the men’s health program, and has a background in psychiatry and care of the elderly. In former times, Jim was director of care at Simon Fraser Lodge and clinical coordinator at the Brain Injury Group. He came to Canada from Glasgow, Scotland 20 years ago and, when not at work, Jim plays in the band Out of Alba and spends time with his family.

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